title: A single case study of a family-centred intervention with a young girl with cerebral palsy who is a multimodal communicator.
abstract: BACKGROUND
  This paper describes the impact of a family-centred intervention that used video to enhance communication in a young girl with cerebral palsy. This single case study describes how the video-based intervention worked in the context of multimodal communication, which included high-tech augmentative and alternative communication (AAC) device use. This paper includes the family's perspective of the video intervention and they describe the impact of it on their family.
  
  
  METHODS
  This single case study was based on the premise that the video interaction guidance intervention would increase attentiveness between participants during communication. It tests a hypothesis that eye gaze is a fundamental prerequisite for all communicative initiatives, regardless of modality in the child. Multimodality is described as the range of communicative behaviours used by the child and these are coded as AAC communication, vocalizations (intelligible and unintelligible), sign communication, nodding and pointing. Change was analysed over time with multiple testing both pre and post intervention. Data were analysed within INTERACT, a computer software to analyse behaviourally observed data. Behaviours were analysed for frequency and duration, contingency and co-occurrence.
  
  
  RESULTS
  Results indicated increased duration of mother's and girl's eye gaze, increased frequency and duration in AAC communication by the girl and significant change in frequency [χ(2) (5, n = 1) = 13.25, P < 0.05] and duration [χ(2) (5, n = 1) = 12.57, P < 0.05] of the girl's multimodal communicative behaviours. Contingency and co-occurrence analysis indicated that mother's eye gaze followed by AAC communication was the most prominent change between the pre- and post-intervention assessments.
  
  
  CONCLUSIONS
  There was a trend for increased eye gaze in both mum and girl and AAC communication in the girl following the video intervention. The family's perspective concurs with the results.
authors.affiliation: NIHR National Biomedical Research Unit in Hearing, University of Nottingham, UK.
authors.forename: M B
authors.initials: MB
authors.lastname: Wadnerkar
authors.forename: T
authors.initials: T
authors.lastname: Pirinen
authors.forename: R
authors.initials: R
authors.lastname: Haines-Bazrafshan
authors.forename: J
authors.initials: J
authors.lastname: Rodgers
authors.forename: D
authors.initials: D
authors.lastname: James
mesh_terms: D002547:Cerebral Palsy / Q000523:psychology / Q000534:rehabilitation*; D002648:Child; D003147:Communication Disorders / Q000209:etiology / Q000534:rehabilitation*; D005133:Eye Movements; D005192:Family Health; D005260:Female; D006801:Humans; D010287:Parent-Child Relations; D014741:Video Recording